Laserfiche WebLink
Amendment <br />Disbursements Pg of _ ❑ Yes No <br />Use this form to report expenditures from the committee for, operating expenses, contributions to candidate/politics! o <br />committees and coordinated partv expenditures. <br />1. Committee Full Name (and Fund if a livable) <br />12. ID Number <br />C4 Yl�M i ft ' +C Eie-V-A T;i-L CIZKK t'V O GLR r <br />3. Tvve of Disbursement lease use se arate CRO-1310 jLorms for each Uge o isbursentent. <br />Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures <br />A. Payee Information LJ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />include city, state, & 'i <br />b. Coordinated Committee Name <br />d_ Comments <br />L r 1 <br />.So iaf62 I=rnowi- r5 �s ��1i T 1�11SCr� <br />lDr <br />Rai, <br />7 <br />� <br />c. Level Registered (Specify) <br />Federal County- <br />❑ State ❑ Municipality: <br />e. Election Sum to Date <br />f Account Code <br />g. Form of Payment <br />h- Purpose Code <br />L Date (mmlddlyyyy) <br />j. Amount <br />k. Required Remarks <br />J <br />IDi-,-t+ <br />a <br />0'1 i �?%tv�B <br />$ f VV <br />4. Payee information ❑ Add ❑ Remove <br />a. Fall Name, Mailing Address & Phone <br />include city, state, & ) <br />b. Coordinated Committee Name <br />d. Comments <br />by Pa; rv1CL-D''1' f r <br />C ����) t g �D� <br />7o4- NY- 34- <br />c. Level Registered (Specify) <br />El Federal Li County: <br />❑ State El municipality: <br />e. Election Sum to Date <br />$ /fib �>a <br />f. Account Code <br />g. Form of Paylwnt <br />b. Purpose Code <br />L Date (mmiddlyyyy) <br />j. Amount <br />k- Required Remarks <br />4 % ,z 3 <br />$ <br />D.0 f- <br />�A <br />L <br />4. Payee Information ❑ Add ❑ Remove <br />a. Full dame, Mailing Address & Phone <br />include city, state & zip) <br />b. Coordinated Committee Namc <br />d. Comments <br />1 d- ✓ <br />7o � _ �ff9 - J-f4 <br />c. level Registered (Specify) <br />Federal ❑ County: <br />El state El Municipality: <br />e. Election Sum to Date <br />$ /67. �o <br />f. Account Code <br />g. Form of Payment <br />h- Purpose Cade <br />L Date (mm/dd/yyyy) <br />j- Amount <br />k. Required Remarks <br />Page G' C' <br />5. Total only this <br />6. Total of ALL CRO-1310 Pages i <br />(This line goes in line 731r of Detailed Summary Page CRO-1100 if Operating Expenses) .s00 <br />(This line goes in line 13b of Detailed Summary Page CRO-1100 if Contrib to CandidateVPolitical Comm) <br />(This line goes in line 13c of Detailed Summary Page CRO-1100 if Coordinated Parry Expenditures) <br />7. Purpose Codes (List detailed expenditure code in (h.) above) <br />A* - Media B* - Printing C* - Fundraising D - To Another Candidate <br />E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses <br />I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund <br />O* - Other <br />* Codes require detailed explanation in required remarks field (k) <br />CRO-1310 NC State Board of Elections December 2009 <br />